Clean Cities, Healthy Lives: Role of Waste Management in Public Health

Authors – Rishabh Gautam, Meghna Thakur, Anoushka, Malavika Anil, Purva Rathore

• Introduction: Rapid urbanization and escalating consumption patterns have intensified the challenge of municipal solid waste management globally, particularly in developing nations (United Nations Environment Programme [UNEP], 2015). The direct correlation between effective waste disposal and public health outcomes is undeniable, as inadequate waste management facilitates the proliferation of disease vectors, contaminates vital resources, and degrades overall environmental quality (World Health Organization [WHO], 2022). This article explores the intricate relationship between waste management practices and public health, focusing on the multifaceted impacts of improper waste handling. It examines the specific challenges faced by urban centers, the efficacy of various waste management strategies, and the critical role of community engagement and policy frameworks in fostering sustainable and healthy cities. By analyzing case studies and current research, this exploration aims to highlight the imperative of integrated waste management systems in safeguarding public health and promoting urban resilience.

• Health hazards of poor waste management: Poor waste management is an important public health concern, as it can lead to a range of health hazards, including the spread of diseases, respiratory problems, and even cancer (Adewoyin, 2017). Effective waste management plays an important role in safeguarding public health. Poor waste management practices contribute to various health hazards, particularly in developing countries where infrastructure and regulatory frameworks may be inadequate (Gupta et al., 2020). The management of solid waste, mainly through incineration and landfills releases a number of toxic substances, most in small quantities and at extremely low levels (Brunner, 2012).

Open waste burning is a common practice in regions with inadequate waste disposal system which cause release of harmful pollutants such as particulate matter, carbon monoxide, and dioxins. These pollutants have been linked to respiratory diseases, including asthma, bronchitis, and chronic obstructive pulmonary disease (COPD). Long-term exposure to air pollutants from waste burning increases the risk of lung cancer. In India, cities like Delhi experience severe air pollution due to waste burning, contributing to an increase in respiratory disorders (WHO, 2021).

Improper disposal of hazardous and non-hazardous waste often leads to leachate formation, which contaminates surface and groundwater sources (Alam et al., 2022). Contaminated water is a major source of diseases such as cholera, typhoid, and hepatitis A (WHO, 2020). Research by Ahmed et al. (2021) found a direct correlation between poorly managed landfill sites and the prevalence of waterborne diseases in nearby communities. In India, groundwater contamination from landfill leachates in cities like Mumbai and Bangalore has raised significant health concerns (Chakraborty et al., 2021).

Accumulation of solid waste serves as a breeding ground for vectors like mosquitoes, rodents, and flies. These vectors transmit diseases such as malaria, dengue fever, and leptospirosis (Sharma et al., 2021). A study by Ghosh et al. (2022) reported a 40% increase in dengue cases in urban areas with inadequate waste management systems. India has seen recurrent dengue and chikungunya outbreaks due to poor waste disposal practices particularly in metropolitan cities like Kolkata and Chennai (WHO, 2021).

Dumping of untreated waste leads to soil contamination with heavy metals, pesticides, and other hazardous chemicals (Patel et al., 2021). Prolonged exposure to contaminated soil has been linked to skin infections, neurological disorders, and reproductive health issues. Communities residing near open dumpsites exhibited higher incidences of skin and gastrointestinal diseases (Kumar et al., 2022). In India, industrial waste disposal in regions like Gujarat has led to high levels of heavy metal contamination in soil, posing long-term health risks (Sharma & Singh, 2022).In India, informal waste pickers, who rely on poorly managed landfills for livelihood, suffer from mental and physical health issues due to continuous exposure to hazardous waste (WHO, 2021).

Depending on the type of exposure and population affected there are two types of health hazards of poor waste management: 1.  Direct Health Hazards 2.  Indirect Health Hazards. 

2.1. Direct health hazards: Direct health hazards of poor waste management include the spread of diseases such as malaria, dengue fever, and leptospirosis etc. Waste management workers are also at risk of accidents and musculoskeletal problems, as well as gastrointestinal tract problems, headache, fatigue, and airways symptoms. Improper disposal of hazardous waste can result in soil contamination, impacting food safety and potentially causing cancer and neurological disorders (Kumar et al., 2017)

2.2. Indirect health hazards: Indirect health hazards of poor waste management include consumption of contaminated water, soil, and air. This can lead to a range of health problems, including respiratory diseases, negative mental health effects, and even mortality. The health impacts of poor waste management can also be seen in the form of land pollution, water pollution, air pollution, climate change, disease, plant death, animal and marine death, and loss of habitats (Kumar et al., 2017).

• Role of Waste Segregation in Disease Prevention: Waste segregation refers to the process of separating different types of waste at the source of generation into categories such as organic, inorganic, recyclable and hazardous waste (Kumar et al., 2017). This process is essential in preventing the mixing of different types of waste, which can lead to the creation of toxic compounds and the spread of diseases. According to the World Health Organization (WHO), “waste segregation is a critical step in the waste management hierarchy, as it allows for the safe and efficient handling, storage, and disposal of waste” (WHO, 2018). 

3.1 Types of Waste Segregation: There are several types of waste segregation,  including:

3.1.1 Source Segregation.

3.1.2 Centralized Segregation.

3.1.3 Decentralized Segregation.

3.1.1 Source Segregation: This involves segregation of waste at the source of generation, typically into categories such as organic, inorganic, recyclable, and hazardous waste.

3.1.2 Centralized Segregation: This involves collection of waste from households and businesses and segregating it at a central location.

3.1.3 Decentralized Segregation: This involves segregation of waste at the community level, typically through the use of community composting programs or recycling centers.

Waste segregation plays an important role in preventing the spread of diseases, particularly those which are caused by vectors such as mosquitoes, flies, and rodents. When waste is not segregated, it can attract these vectors which can then spread diseases. Exposure to improperly managed waste, including toxins from electronic waste can lead to severe health issues such as respiratory disorders and neurological damage, highlighting the need for systematic waste segregation. For example, a study conducted in India found that the segregation of organic waste from inorganic waste reduced the incidence of dengue fever by 30% (Sharma et al., 2019). Waste segregation also helps in prevention of the spread of waterborne diseases, such as cholera and typhoid fever. When waste is not segregated, it can contaminate water sources, leading to the spread of these diseases.

3.2 Benefits of waste segregation:

1. Waste segregation helps to prevent the spread of diseases by reducing the risk of vector-borne diseases and waterborne diseases.
2. Waste segregation enables the efficient and safe handling, storage, and disposal of waste (WHO, 2018).

iii. Waste segregation helps to conserve natural resources by reducing the amount of waste sent to landfills and promoting recycling.

1. Waste segregation can help to reduce the amount of particulate matter and other pollutants in the air, which can contribute to respiratory problems such as asthma and chronic obstructive pulmonary disease (COPD).
2. Waste segregation can help to improve mental health by reducing stress and anxiety related to living in a dirty and unhealthy environment.

3.3 Challenges and Limitations: Waste segregation has numerous advantages but there are some challenges and limitations that must be overcome. Some of the major challenges are:

• • Limited Infrastructure: In many cities, the limited infrastructure for waste segregation makes it difficult to implement effective waste segregation programs.

• Lack of awareness: Many people are not aware of the importance of waste segregation and the benefits it provides.

• Lack of enforcement: In some cities, lack of enforcement of waste segregation regulations makes it difficult to ensure compliance.

4. Plastic waste and its impact on urban health : The world is facing an uncommon crisis in the form of plastic waste, which has become a significant threat to public health, particularly in urban areas. The improper disposal of plastic waste has severe consequences on the environment and human health.

Plastic waste has become a universal problem in urban areas, with millions of tons of plastic waste generated every year. The lack of proper waste management infrastructure, inadequate waste collection, and inefficient disposal methods have led to the accumulation of plastic waste in streets, drains, and water bodies. This has resulted in the contamination of soil, air, and water, posing a significant risk to human health. Plastic waste has gained more attention compared to other types of waste, due to its detrimental impacts on the environment and humans (Al-Mosawi et al., 2017, Sokolova et al., 2023).

While plastic has revolutionized industries with its convenience and durability, its improper disposal poses a severe threat to urban health. The link between clean cities and healthy lives is evident, as inadequate waste management exacerbates pollution, health risks, and environmental degradation.

4.1 The Growing Burden of Plastic Waste in Urban Areas: Urban areas generate a major amount of plastic waste in daily routine, which includes packaging, single-use plastic and many more. The demand for plastic material has risen drastically in urban centers. India’s per capita plastic consumption has grown to approximately 11 kg per year, and this number is expected to rise further with increasing industrialization and consumerism. Plastic accumulation in landfills, streets and water bodies is the result of inadequate collection of waste, lack of segregation and mismanagement in disposing of plastic waste properly. This unmanaged plastic waste disrupts drainage systems, leading to waterlogging and increasing the risk of vector-borne diseases such as malaria and dengue.

4.2 Health Hazards Associated with Plastic Waste: Plastic waste impact urban health in many ways, that are:

4.2.1 Water Contamination: Plastic waste clogs drains and water channels, leading to stagnant water that becomes a breeding ground for mosquitoes and bacteria, causing outbreaks of cholera and typhoid and many more vector borne diseases such as malaria and dengue. It has become a major issue as water is an essential requirement for everybody like for humans, animals as well as for plants.

4.2.2 Air Pollution: The amount of plastic that gets burned is estimated to be as high as the quantity of plastics emitted into the land or sea. The open burning of plastic releases toxic chemicals like dioxins and furans, which cause respiratory diseases, cardiovascular problems, neurological disorders and even cancer. One study attributed 90% of black carbon emitted from burning wastes to two plastics—polyethylene terephthalate and polystyrene.

4.2.3.    Microplastics in Food and Water: Studies show that plastic particles enter urban water supplies and food sources, increasing the risk of digestive and endocrine disorders. Microplastics can enter plants through the soil from plastic mulches used to improve water and nutrient efficiency. It can impact the health of humans as well as plants by causing diseases such as inflammation, neurotoxicity and many more.

4.3.4.     Soil Pollution: Large pieces of plastic break down into microplastics, which seep into the soil. These plastics can release harmful chemicals into the soil. Plastic leachates contaminate soil and enter the food chain, affecting agricultural productivity and human health. These can affect plants by reducing the root growth and nutrient uptake and slowly decreasing the number of species that live in soil, such as larvae and mites.

Plastic waste presents a significant threat to urban health by contributing to air, water, and soil pollution, as well as facilitating disease transmission. The adoption of sustainable waste management strategies is crucial to mitigating these risks and ensuring healthier urban environments. Collaborative efforts between governments, industries, and the public are necessary to combat plastic pollution effectively and safeguard public health.

5. Biomedical and hazardous waste management: Biomedical wastes are trash and materials that come from hospitals, labs, and research operations and represent a considerable risk. Biomedical waste may impair both the environment and human health by releasing harmful elements into the environment and transmitting infectious diseases, particularly through wounds from sharp instruments. Harpreet  Singh et al.,(2024). Therefore, it must be properly treated and disposed of to save the environment and public health. Deepika Kanyal et al.,(2021)

According to the World Health Organisation health report 2018, over 85% of BMW’s total volume is classified as non-hazardous waste, and the remaining 15% is classified as infectious hazardous waste. Trinjana Diwan et al.,(2023)

According to WHO, medical waste is classified into: infectious waste, pathological waste, chemical waste, sharps, cytotoxic waste, radioactive waste, and general waste.

Hazardous biomedical waste (BMW) management involves segregating, containing, transporting, treating, and disposing of waste safely. The procedures are as follows: segregation, containment, treatment, transportation, and disposal.

According to the BMW Rule 2016, every healthcare institution must take all necessary measures to guarantee that BMW is handled in a way that does not harm human or environmental health. Bansod et al.,(2023)

5.1 Hazardous and biomedical waste management procedures include:

5.1.1. Waste Segregation : Hazardous and biomedical waste must be properly separated at the time of generation. Waste must be categorized into multiple streams, such as

•       Infectious Waste: Polluted items such as surgical waste, sharps, animal waste, etc.
•       Non-infectious garbage: general waste that doesn’t have the potential to spread illness.
•       Hazardous waste includes chemicals, medications, and other potentially dangerous materials.

Waste segregation is also done by using colour-coded bins, based on which they are handled and disposed. Bansod et al.,(2023)

5.1.2. Regulatory Compliance : Local, national, and international waste management rules must be followed by healthcare facilities and business enterprises such as:

• The Resource Conservation and Recovery Act (RCRA) in the US.
• The European Union Waste Framework Directive.
• WHO standards for safe biomedical waste handling.

5.1.3. Technologies for Treatment : Numerous treatment techniques are used to handle hazardous and biomedical waste, such as:

• Autoclaving: An effective way to sterilise infectious waste using steam. Sudhir Agrawal et  al.,(2011)
• Incineration: This process reduces the volume and toxicity of hazardous waste by burning it at high temperature Ezaldin Hassan et al.,(2024).
• Chemical Treatment: Before being disposed of, dangerous substances must be neutralised.

Biomedical waste, including sharps, should be stored, transported, or disposed of in solid, leak-proof containers that are appropriately labelled, sealed, and break- and puncture-resistant. It is important to store sharps and other biological waste in plastic bags that are sturdy enough to not tear and that don’t leak. Sudhir Agrawal et al.,(2011)

5.1.4. Staff Training and Public Awareness : Healthcare professionals and waste management specialists must be trained to ensure that waste management standards are followed. Regular training sessions and seminars help raise awareness of the hazards connected with incorrect trash disposal. Raising public knowledge may also generate community support and urge healthcare practitioners to adopt responsible practices.

5.2. Solutions for the management of Biomedical Waste

• Reducing waste and preventing at source: The waste management hierarchy prioritises waste reduction and prevention as the first and most important step. Sudhir Agrawal et al.,(2011)
• Hazardous waste producing inventory According to hazardous waste regulations, industries can only store hazardous waste for no longer than ninety days.
•  Reuse, recycling, and hazardous waste recovery: Encourage the use of Waste exchange centres for reuse, recycling, and waste recovery. Sudhir Agrawal et al.,(2011)
• Infrastructure Development: Investing in waste management infrastructure, including collection, transportation, and disposal facilities, is vital. Governments and healthcare institutions should work together to build long-lasting waste management solutions.
• Financial assistance and funding: Financial support for healthcare companies to develop sustainable waste management methods can promote compliance. This includes incentives and subsidies for firms that implement effective waste management systems.

5.3 Problems in Handling Biomedical and Hazardous Waste

1. Insufficient Training and Knowledge: Many medical professionals incorrectly separate and dispose of garbage due to inadequate waste management training.
2. Inadequate Facilities: Inadequate infrastructure for garbage collection, treatment, and disposal can lead to environmental pollution in some locations.
3. Regulation Omissions: Unreliable laws and enforcement result in noncompliance and hazardous waste management techniques.
4. Budgetary Limitations: When funds are limited, it makes it difficult to construct waste management systems effectively.

Biomedical waste, which includes any waste produced in hospitals, labs, and research centres, presents particular difficulties since it can spread contagious illnesses and damage the environment. Ezaldin Hassan et al.,(2024). To safeguard the environment and public health, various waste kinds must be managed effectively. Even if there are obstacles, healthcare institutions’ waste management procedures may be greatly enhanced by putting specific solutions into place. stakeholders can work together to create a safer and more sustainable future by investing in education, infrastructure, regulatory compliance, and public awareness.

6. Sustainable Waste Management Practices and Public Health: Sustainable waste management is a cornerstone of public health, yet its effectiveness depends on holistic strategies that go beyond mere disposal. The widely accepted “reduce, reuse, recycle” (3Rs) framework serves as a guiding principle, but implementation challenges persist, particularly in rapidly urbanizing and resource-constrained regions (European Commission, 2020). Source segregation, the separation of waste at its origin, plays a critical role in reducing contamination and maximizing resource recovery. However, studies indicate that public compliance remains a barrier, often due to a lack of incentives and inadequate infrastructure (IISPPR, n.d.).

Technological advancements offer viable alternatives to traditional landfilling, each with distinct advantages and challenges. Anaerobic digestion transforms organic waste into biogas, providing a renewable energy source while minimizing waste volume (Bernache-Pérez & Peredo-López, 2018). However, high initial costs and limited public-private partnerships often hinder large-scale adoption in developing nations. Similarly, waste-to-energy (WtE) incineration generates electricity from non-recyclable waste but raises concerns regarding air pollution, energy efficiency, and economic viability, particularly in low-income regions with high organic waste content (Satoyama Initiative, 2023). A comparative study suggests that WtE incineration is more effective in countries with advanced emission control measures but may not be a one-size-fits-all solution (Wilson, Velis, & Cheeseman, 2006).

Policy interventions, such as Extended Producer Responsibility (EPR), are critical in shifting waste burdens back to manufacturers, compelling them to design sustainable, recyclable products (European Commission, 2020). However, weak enforcement and corporate pushback often limit its effectiveness in countries with less stringent environmental regulations. Case studies from Indian cities highlight the importance of localized policies, such as deposit-refund schemes and incentive-based recycling models, which have proven successful in improving compliance and waste recovery (IISPPR, n.d.).

Beyond policy and technology, community engagement and informal waste management integration remain pivotal. The informal sector handles 60% of waste recycling in some developing nations, yet workers often face hazardous conditions, social stigma, and lack of legal protection (Wilson et al., 2006). Recognizing their role and formalizing partnerships can enhance efficiency while improving worker safety and income stability.

The impact of waste mismanagement on public health is well-documented. Poor waste disposal contributes to vector-borne diseases (malaria, dengue), respiratory illnesses from air pollution, and waterborne diseases due to leachate contamination (WHO, 2015). A recent study linked unregulated landfill sites in South Asia to a 30% increase in respiratory infections among nearby populations (Satoyama Initiative, 2023). Thus, localized, decentralized solutions, such as biogas plants in Kerala, greywater recycling in rural schools, and community-led composting programs, have demonstrated measurable improvements in both waste management and public health outcomes (IISPPR, n.d.; Satoyama Initiative, 2023).

By addressing technological, policy, economic, and social dimensions, sustainable waste management can significantly reduce environmental pollution, enhance resource conservation, and improve public health. However, its success requires strong governance, financial investment, and active citizen participation, ensuring long-term sustainability in diverse urban and rural landscapes.

7. Conclusion : The evidence presented underscores the indispensable role of robust waste management systems in ensuring public health within urban environments (Wilson et al., 2015). Effective waste segregation, advanced treatment technologies, and sustainable disposal practices are not merely logistical necessities but fundamental components of a healthy and resilient urban ecosystem. Beyond the direct mitigation of disease risks, integrated waste management contributes to environmental sustainability and economic efficiency. The success of these systems, however, hinges on the active participation of communities, the enforcement of stringent regulatory frameworks, and the continuous innovation of waste management technologies (Zerbock, 2003). Moving forward, cities must prioritize the development of comprehensive waste management strategies that are adaptable, inclusive, and responsive to the evolving needs of their populations. By fostering a culture of responsible waste management, urban centers can significantly enhance public health outcomes and create healthier, more sustainable living spaces for all residents.

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